Individual
CARL MICHAEL PESTA SR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
23575 15 MILE RD, CLINTON TOWNSHIP, MI 48035
(586) 759-7494
(734) 677-7407
Mailing address
PO BOX 1108, ANN ARBOR, MI 48106-1108
(586) 759-7494
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101005236
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2798943
—
MI
Enumeration date
06/07/2006
Last updated
07/08/2007
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